In this episode, we speak to Melanie, a public health epidemiologist in the United States, who shares her professional story and background from nursing, public health, and epidemiology. Learn more about the various options available to you in the field of public health!

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April Moreno 3:40

Thank you for joining us for this episode of the public health networker. Joining us in this continuing series of episodes on public health mentoring and careers is Melanie. She is an epidemiologist and she's also a public health nurse. I'm really excited to have this conversation today about public health nursing, and maybe a little bit about epidemiology in the mix as well. Welcome,

Melanie 4:02

Melanie. Thanks, April for having me. Great to be here.

April Moreno 4:06

Thank you so much. So tell us a little bit more about you your background in epidemiology, public health and nursing. Sure.

Melanie 4:15

April Moreno 6:10

And so do you like it? Do you like epidemiology?

Melanie 6:13

Do Yeah, I, about five years after starting as a public health nurse, I decided to go back for graduate school. And I went and got my master's of public health. And while the MPH degree that I saw was technically a generalist program, I did do all of my electives and epidemiologic epidemiologic coursework. So plan B, and biostatistics, any class that I could get that taught those skills I took, and then I just kind of kept that in my back pocket. And that was in the right place at the right time. For when an epidemiology role came along, doing actually what I enjoy most in public health nursing, which was infectious diseases.

April Moreno 6:56

Excellent. So, you know, I find that we're on like, these different sides of the spectrum. Either you love epidemiology, you love statistics, or you don't. So where are you on that spectrum?

Melanie 7:07

So I'll be I'll be honest, like my role, right now does not involve that much in the way of statistical work. There are other FPS at the health department who are more kind of in that heavy duty data, data manipulation and analysis role. I mean, I do I do analysis as well, but not as not as much as the people whose primary job role is for that. I'm a bit more on the applied at the side. So doing things like infection control, advice and case investigation and outbreak mitigation, in the role that I'm in, and, honestly a bit of policy, development, and policy review or advocacy, as well, a lot of building relationships between different stakeholders. So when I was still doing the, the school role, obviously, I interacted with a lot of school health staff, in schools that didn't have school nurses, school, administrators of colleges, trade schools, to kind of be their point of contact in public health as they were, you know, dealing with COVID-19 throughout the first two years of the pandemic.

April Moreno 8:21

Okay, thank you. I love the concept of applied epi I guess I've never really personally heard that conversation before working in public health agencies in the past I've heard you know, seen a lot of epi opportunities and also applied for them where it was just like SAS heavy, like just constant like data programming. And just analysis of big data sets is like what those epidemiologists were doing but I really appreciate this conversation on the applied side and how you know, it doesn't have to be so painful. Yeah, yeah. Yeah,

Melanie 8:56

I mean, I'll be honest, like I wish my like my my statistics skills are okay, but I wish I knew more about programming like the I my MPH program had a certain on stata which is very point and click which was nice as someone who didn't really have that, you know, computer programming background but I like it's not what's used at my health department. So I at some point I'm probably going to have to teach myself are and I'm just really dragging my feet.

April Moreno 9:31

Yeah, I find it to be maybe more enjoyable than SAS. So I personally enjoy are for like, GIS stuff. But yeah, I think I mean, you understand the purpose and you understand when to use what so I think you're going to be totally fine. So, tell us a little bit more about your your experience in public health nursing. And you know what that is Career looks like for people as an alternative.

Yeah, so I actually started as a public health nurse straight out of nursing school, which is not generally the way that that goes. Most of the time in nursing school nurses are told that they need to go work at least two years on a medical surgical unit in a hospital before they can go to another specialty. But that's just not true. But half of nurses actually do not work in an acute care setting. United States there are so many places that nurses can, can go and do it and be nurses and grow. And have often I think, have a really unique perspective, that maybe somebody else without the educational backgrounds or philosophical framework might not. So as a generalist public health nurse, I did a lot. My primary role at first was kind of in a sexual health clinic. So I saw appointments for folks who were coming in to get pregnancy testing, or started on birth control, or who were using birth control, but maybe wanted to change to another method, sexually transmitted infection, and HIV testing and treatment appointments as well, was kind of the purview of the clinic. And then I'd also kind of done some case management for the to the program that we had, and trains to immunizations, did a lot of outreach. So a lot of you know, if someone called the Health Department and like I need someone to come teach sex ed to these, you know, high school biology class, I'd be the person who went out and did that. I served on a lot of community organizations that were kind of focused on the areas of clinic that I worked in. So teen mental health, teen pregnancy prevention, teen sexual health, adolescent health was really my jam. But other other pieces too. I did the HIV program for a little while until we got more funding, and then it became like way more than just one person could do. I worked I did harm reduction. So at the health department, we had, we launched a syringe services program. So where people who use injection drugs can come in, safely dispose of used equipment, and then exchange for new sterile stuff, in order to make a dent in HIV and Hep C rates in the community, but also doing a lot of things like overdose prevention, education, giving Narcan. I mean, administering it in clinic, but giving it to them so that they can be the first responders out in the community with a lot of education coalition around that, then kind of like the final frontier. For me, that's like things to cross train too, because as you can tell, I have the attention span of a squirrel. I was communicable disease control. So that was the final program that was kind of available for me to dip my toes in as a generalist. And I'd been doing that for about a year and a half when the pandemic started. So for the Communicable Disease Control Program, when we received reports from the state health department of, you know, reportable conditions like foodborne illnesses, vaccine preventable diseases, zoonotic travel illnesses. We would the nurses would call those folks to do a case interview and do further follow up and education, maybe get environmental health involved, if we suspected maybe, like unsafe food handling practices at a restaurant, or something like that, for example, or if the, like a childcare had a norovirus outbreak, nor about your season right now. So much. So yeah, just a very, very wide variety of stuff, a lot on the kind of one to one clinical level, but also a lot kind of with the community and relationships building with other organizations as well. And kind of the whole, the care of the of the whole population, that you're that you're serving as a local health department versus just the person that's in front of you in a clinic setting.

So it's interesting to me, I mean, I've, I've, I've worked with public health nurses in the past, we were in the same department, for example, in LA County, I was working in substance abuse prevention and control. And we had public health nurses there in our department. I'm so curious to hear a little bit more about maybe the experience of a public health nurse versus someone like for me, who was a research analyst, I was just kind of working on the policy side and things like that. So I'm curious. So, you know, just to kind of spell this out a little more and describe this experience a little bit for our listeners, public health nurses, it sounds like it's both a community public health, traditional interaction, but it's also kind of a one to one individual patient interaction and at some level, it can

be Yeah, I mean, local pub. because it's so very different anywhere you go in the United States, in Colorado, where I am, public health is very localized. We do have a state health department. But the kind of boots on the ground work is done at the, at the county, at the county level out here, versus somewhere like Wyoming or Alaska, where public health for Maine, where public health is very much at the state level. And while you might be like in the local office, you're still an employee of the state health department, you're not an employee of, you know, the little local township for the county, where you might be here. And so it just kind of depends on what the services that are offered by that health department. Some health departments, like the most clinical that they might get is like maybe they'll do a flu shot clinic in the fall. And that's it. But others in other states, like here, but also in like California, are very, very robust in that one to one kind of services that they provide. Many county health departments also have home visiting programs where nurses may go and visit folks at home for a variety of reasons. pretty commonly, we might see if like, first time parents for first time pregnant parenting folks, or families who might have involvement with like, with human services in like a child abuse or neglect cases, you know, just kind of book an additional resource, you know, to work on parenting skills or resources, or whatever it is. family needs to to be more stable, where kids with special needs doing care coordination. There's just a million things that that we can do. It just kind of depends on what, what that local health department offers.

Okay. Yeah. So I'm curious about, you know, with a public health nurses role, let's say someone's interested, maybe they've done a bachelor's in public health. Can you tell us a little did it freeze? Is or are we okay? No. Oh, there you are. Okay. Oh, yeah. The internet's a little funny right now, I guess. So I was just curious. So for example, if someone were doing a bachelor's in public health or something, and then they were interested in learning about public health nursing, what would you tell them? How, how could they get started? Tell us what are the highlights of public health and nursing?

Sure. So if someone is wanting to be a public health nurse, obviously you need a nursing license. Can't really do that without that. So most, I'd say not. Again, it's kind of depends where you are. But much of the time a bachelors of science of nursing is the the baseline entry educational requirement for public health nursing. In some states like California, there might be an additional certification that you need to obtain to in order to be called a public health nurse. And then in, in other places, particularly more rural areas, an associate's degree in nursing is also fine. So a two year degrees of a four year degree. And some places will also hire a licensed vocational nurse or LPN, which is typically a one year program plus it's other prerequisites for someone who has a bachelor's in public health or, or other bachelors. There are also educational programs that are what we call kind of accelerated bachelors of science of nursing are a BSN programs, which are for folks who have who have a bachelor's in something else that's not nursing. And then they kind of go through this trial by fire and, you know, 15 to 812 to 1218 month program to pop out with their their bachelor's in science of nursing. And then they can take their licensure exam. So, I mean, you need a nursing license for that. And then generally, the educational floor will be a bachelor's in science in nursing. The I would say it's helpful to like if someone is interviewing to be a public health nurse for the first time. It's it's hard to find experienced public health nurses, we're kind of kind of rarer than hen's teeth, sometimes for filling an existing position. And many places, may hire new grads, not not not all do, but if you're kind of putting your toe in for public health nursing for the first time, it helps to be able to demonstrate, you know, some aspect of community care. So if you're volunteering at you like a medical clinic that provides you know free care for people experiencing homelessness. Yes. Or you volunteer with a a syringe. Access or harm reduction program, or just something, something that shows that you're aware that health disparities exist, and that you care about making a difference about them, and working with populations that are, you know, historically and presently marginalized or disenfranchised, because that's often who you're serving in, when you're doing that one to one care that a public health nurse may provide.

Thank you. And so I'm just imagining, you know, if someone were to listen to this episode, I do want to share it with people who I do know who are nurses are interested in nursing as well, and how we can bridge public health and nursing together. And I think that's a wonderful combination of things. So I can, I am guessing that because of the need of what happened with the pandemic, you saw, that there was this need for more epidemiological assistance, so you proceeded into the Master's of Public Health, and then you got your epidemiology, kind of credentials or whatever, so that you could work in the field in in this specific capacity. If the nursing opportunities were to arise again, in the future, is that something you're still looking into,

I could see myself going back to a generalist kind of public health nursing role, I don't think acute care will ever be for me. But I mean, I enjoy care of the community and care of the population. So I could see that, but I'm really enjoying kind of exploring this, this new avenue that's open to me, kind of my my next kind of career goal is to get certified as an infection preventionist. So that I can do more in this kind of communicable disease control role that I'm in, it's been moved from. So I'm no longer working on COVID response, I'm just kind of gone back to General communicable disease control. So kind of a little rusty on that, but I still remember how to do a camp, I look back through interviews, I'll get there. That's kind of where where I'm hoping to go next. I don't know that I'll jump job roles anytime soon. But I like to have a myriad of experience so that, you know, if I decide I want to do something else, I have the skill set to be able to do it.

And then that so the you have the opportunity to change different fields, the different types of even disease folk focuses full size. So you can do all of these different things now. And if you choose to go back into public health nursing that's available to you as an option as well. I like that you have all of these different experiences. And basically just as the different needs arise as it began with the pandemic. I think that's wonderful, just sharing your story with us about how very public health can be. And even within one career, how the different varieties of tasks and capacities and disease groups topics can be. Yes. So what advice would you give to someone who is maybe opening this new door into considering the field of public health nursing.

So first, if they're not already a member of their state Public Health Association, I would really encourage that they join up or at least, you know, attend a virtual networking event or in person if you're comfortable with that. And they're hosting. Because that is the way you're going to find public health nursing jobs is, you know, those are the movers and shakers of public health in your local area. So getting to know them and be familiar with volunteer, volunteering with them, if they have initiatives going on is going to be a great way to get that foot in the door. I would also it's a misconception. I think with public health nursing that you need a master's degree in order to do this job. You really don't I mean, it helps if you want to go into advanced roles, like the one that I'm doing. Or if you want to look into like program management, or if you want to be you know, a supervisor or something typically, you would need a graduate degree of some sort for that. So I think it's Yeah, I think a lot of nurses think that you have to have a master's to do this. And sometimes yes, but generally for most entry roles, you don't. So yeah, get involved with your local affiliate for American Public Health Association. And yeah, just start there. And if someone you know, if a nurse is interested in chatting, public health nursing, I'm available on Twitter as well at MrogersRN, is my handle.

Thank you so much. So again, that was MROGERSRN. Okay, thank you so much. And any last, I guess my last question for you is kind of where do you see yourself in, like, let's say, three years from now? Where would you like to be three years from now?

Say three years from now, I would like to have a side gig doing Public Health Consulting, possibly, or maybe career change into a global health role, taking the experience that I've had so far as a generalist public health nurse, but then also as an epidemiologist, because I think there's, there's a lot of things that nurses with advanced Public Health Training can do, can do out there and can do a lot of good. And I'd like to put my talents to making wherever I am, you know, a better place for the people that I work with.

Thank you so much. I agree with you. I think that from what I've seen in the nursing field, that there is so much variety of opportunity in the field. There's just so much that can be done, even just into administrative leadership. And now you've got that combination with public health, which is also another whole other set of options. So you've got a lot that you can offer as a consultant for the future. So I'm there to support you. I'm your ad while on and, and I wish you all the best. Thank you so much for joining us for this episode today. Sure, thanks. Thank you